مقدمة في النظام الصحي

Introduction to The Health System

• The presentation is about the concepts and functions of the health system.
• The presenter is Dr. Suleiman Abdgabbar Abdullah, a Community Medicine specialist.
• Date of presentation: 3/13/2022

Learning Objectives

• Students will understand the definitions, concepts, and functions of health, the health system, and healthcare delivery.
• Students will be able to describe roles, responsibilities, and organizational charts of different levels of health system management in Sudan.

Session Outlines

• Definition and concepts of health, healthcare, and health system.
• Health system functions.
• Roles, responsibilities, and organizational chart of the Federal Ministry of Health.
• Roles, responsibilities, and organizational chart of the State Ministry of Health.
• Roles, responsibilities, and organizational chart of the Local Health System.

Definition of Health

• "Health is a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity."
• This definition has been expanded in recent years to include the ability to lead a "socially and economically productive life."
• The definition is attributed to the WHO (1948).

Dimensions of Health

• Health is multidimensional.
• The WHO definition considers three key dimensions: physical, mental, and social.
• Other dimensions can be included, including spiritual, emotional, vocational and political dimensions.

Healthcare

• "Healthcare is the maintenance or improvement of health through promotion, prevention, diagnosis, treatment, recovery/cure, and rehabilitation of disease, illness, injury, and other physical and mental impairments in people."

Healthcare Delivery System

• Part of the health system.
• An organization of people, institutions, and resources responsible for delivering healthcare services aligning to the health needs of target populations.

Health System Functions

• Providing health services as a fundamental human right.
• Generating human and physical resources to enable efficient service delivery.
• Raising and pooling resources for healthcare financing.
• Providing stewardship—setting and enforcing rules and providing strategic direction for all different players.

Operational Definition of Health System

• "All activities and resources directed towards promotion, protection, restoration, maintenance, and rehabilitation of health."

World Health Organization Health System Framework

• A framework with different categories that include:
  • Leadership and governance.
  • Health care financing.
  • Health workforce.
  • Medical products, technologies.
  • Information and research.
  • Service delivery.
  • Access and Coverage.
  • Quality and Safety.
  • Goals and Outcomes (e.g., improved health, financial risk protection, improved efficiency).

Levels of Health System Management

• The presentation displays the levels of health system management as a hierarchy with Federal, State, and Locality levels.

Roles and Responsibilities of the Federal Ministry of Health (FMoH)

• Develops national policies, legislation, and plans.
• Monitors and evaluates implementation of policies and plans.
• Sets standards and specifications for healthcare systems.
• Supervises and guides efforts to control disease and epidemics.
• Supports state ministries in building their capacities.
• Leads Human Resource for Health (HRH) development.
• Supports provision of effective, safe, affordable, and quality supplies.
• Leads development of Health Information System (HIS).

Organizational Chart of FMoH

• The presentation includes a hierarchical organizational chart for the Federal Ministry of Health, showing different departments and divisions (e.g., Administration, Pharmacy, Curative Medicine, Human Resources for Health, Public Health, etc.)

Roles and Responsibilities of the State Ministry of Health (SMoH)

• Develops and implements state policies, legislation, and plans in line with national ones.
• Provides funds for different health projects and activities.
• Establishes and runs different types of hospitals, complying with national standards and specifications.
• Licenses different types of health facilities.
• Conducts health surveys.
• Provides vital registration and statistics.
• Controls contaminants and air pollutants.
• Manages emergency preparedness and response to health epidemics and emergencies.
• Manages medical supply management.
• Supports localities to build their capacities.

Organizational Chart of SMoH

• A hierarchical organizational chart is provided, outlining different directorates and departments within the State Ministry.

Roles and Responsibilities of the Local Health System (LHS)

• The presentation identifies the principles and functions of the LHS.
• It is part of the national health system, based on a Primary Health Care (PHC) concept and serves the population within a specific geographical area (locality).
• It is divided into Local Health Areas (LHAs).
• It identifies and secures local health needs according to national standards.
• It ensures effective leadership and partnerships at the local level.
• It coordinates between partners and mobilizes additional resources.
• It addresses the provision of funds for health activities and utilizes resources efficiently.
• It oversees organization structures, including the Locality Health Council, Locality Health Management Team, catchment area health team, and Community Health Committee (e.g., Village Health Committee, District Health Committee).

Roles of the Locality Health Council

• Endorses health plans.
• Supports the Locality Health Management Team (LHMT) in implementing plans.
• Activates political commitment.
• Coordinates resources.
• Develops and endorses supportive legislations.
• Monitors progress.

Role of the Executive Director

• Leads the Local Health System (LHS) toward its goals.
• Ensures effective political commitment.

Effective Political Commitment

• To achieve effective political commitment, various crucial elements are necessary, including:
  • Providing local budgets for health plans.
  • Supporting legislation and policies.
  • Effectively mobilizing communities.
  • Coordinating between different partners in the health sector.
  • Mobilizing resources for health initiatives.
  • Building strong partnerships.
  • Ensuring sufficient human resources for health (HRH).
  • Spreading awareness and information about health topics

Roles and Responsibilities of the Locality Health Management Team (LHMT)

• Manages healthcare services (planning, organizing, staffing, financing, controlling).
• Provides integrated services.
• Coordinates with other sectors.
• Ensures community participation.
• Manages health information systems (HIS).
• Trains health workers and volunteers.
• Provides resources for effective LHS functioning.

LHM Organization Chart (one model)

• Presentation shows a model organizational chart for the LHMT.

LHT Organization Chart (one model)

• Presentation features a model organizational chart of the Local Health Team (LHT), illustrating a structure with different sections (e.g., health centers, environmental health, maternal and child health (MCH), disease control, hospitals).

Roles and Responsibilities of Catchment Area Committee

• Identifying priorities.
• Monitoring implementation of plans.
• Supporting health workers.
• Engaging community in participation efforts.

Roles and Responsibilities of Community Health Committee

• Identifying priorities.
• Monitoring implementation of plans.
• Supporting health workers.
• Engaging and mobilizing the community to participate in health activities.

Learning Objectives (repeated)

• Understanding the definitions, concepts, and functions of health, the health system, and healthcare delivery.
• Describing roles, responsibilities, and organizational charts for various levels of health system management in Sudan.

References

• National Health Policy (2017-2030).
• National Health Sector Strategic Plan II (2017-2020).
• Sudan Health System Profile (2006)—WHO Regional Health Systems Observatory - EMRO.
• Sudan Household Health Survey (2010).
• Sudan Health Status Report (2010).
• Other documents (e.g., Sudan health sector standards and specifications).
• Addressing the need for health services expansion in Sudan.
• Website resources.